Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count

Area of Science:

• Healthcare Management
• Medical Ethics
• Patient-Centered Care

Background:

• Shared decision-making (SDM) is advocated for optimal healthcare choices, integrating scientific evidence with patient values.
• The emergency department (ED) presents unique environmental challenges to implementing SDM.
• Physicians report multiple management options for over 50% of ED patients, using SDM in 58% of cases.

Purpose of the Study:

• To describe the conceptual model of SDM by Charles and Gafni.
• To highlight SDM's relevance to emergency medicine (EM) practice.
• To explore ethical and pragmatic implications of SDM in the ED.

Main Methods:

• Conceptual model description.
• Clinical vignettes from practice.
• Exploration of ethical and pragmatic implications.

Main Results:

• SDM is applicable to contemporary EM practice.
• Ethical and pragmatic considerations for SDM in the ED are explored.

Conclusions:

• SDM is a valuable approach for emergency medicine.
• Further discussion and research on SDM in the ED are needed.